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Campaign to recruit GPs from abroad misses target

A health service scheme to entice GPs from abroad to work in England has signed up only 100, well short of the 600 who were promised by April.

NHS England launched the initiative, at a cost of £100 million, in August, intending that 2,000 to 3,000 doctors should join the service from overseas by 2020. GPs said waiting times for appointments would increase if the target was missed.

Speaking to the GP magazine Pulse, Dr Arvind Madan, national director for primary care, said at the time: “By April 2018, we are aiming to have appointed 600 GPs who will be available to practices.”

An NHS England spokesman said in clarification: “The 600 appointed means they’ll be in the system but not necessarily at their desk in practices as they will have to move and be sorting out logistics etc.” Papers presented this week to the NHS England board said recruiters were “reporting that a total of 100 GPs are expected to be recruited by March 31”.

Marie
Successive governments have turned a blind eye to this crisis. A complete failure to plan and invest in our own doctors yet send Foreign Aid to train those needed in their countries. Crazy.

A medical trainee starting in entry 2000 will have been based upon Treasury numbers calculated in 1990. Given that medical training lasts between 5 – 7 years and is then followed by statutory post qualification of up to 10 years to train as a GP or consultant, you can see just how long it takes to train just one doctor. Royal College examination costs are also eye watering.

Jeremy Hunt keeps blaming the elderly for the increased demand upon the NHS although the government has known about our own ‘indigenous’ elderly from live birth registers and NI contributions for planning purposes. The real spike in demand is as a result of significantly increased immigration post 2000 and is only being mildy acknowledged of late. To say nothing of health tourism and those who deliberale fly in to the UK to have their babies and/or complex operations.

Add into the mix of wanting excellent doctors (a must) entry qualifications to medical schools are exceedingly high and removes many from gaining a place. Standards need to be kept high. Some disappointed and rejected medical students are choosing to train in countries like Somalia to get around not being accepted into medical school then return. Ask yourself what must the quality of training look like?

Training doctors have never been awarded bursaries (unlike nurses) and as the professional training is so long it requires real financial commitment on the part of a trainee and / or their parents. Career changers have few incentives. It does nothing to recruit our own.

The door has been banged shut for bright children in working class communities who are unlikely to be unable to sustain the high costs involved in their training including mandatory International Medicine where trainee doctors work abroad and fund it entirely by themselves.

There is frequent publicity about training to teach and being able to attract bursaries of up to £27k p.a. but nothing regarding providing incentives to attract students to train in our medical schools. Why? Add in tuition costs to such long training compared with other degrees and the commitment becomes an overwhelming millstone of a burden.

So Treasury numbers have been well out of sync with actual need. New doctors also face poor pay and demanding work patterns in extremely challenging environments. Recruiting doctors from overseas is not the answer. Standard of training cannot be truly validated and often there are communication skills deficits as well as removing a resource needed in their own country. Hunt will tell you that foreign doctors receive a year’s training here when they start. However, they are straight into post and given just a year’s mentoring.

Blair and May have done nothing to consider the doctor flows in to the profession but have settled for a pipe dream of hoping for a foreign supply stream as the answer. It isn’t. TraIn our own.

tutti fruiti
Interesting piece that you have written. you clearly know your subject well.
“Royal College examination costs are also eye-watering.” I had thought they were some £500 – £700
“There is frequent publicity about training to teach and being able to attract bursaries of up to £27k p.a. but nothing regarding providing incentives to attract students to train in our medical schools. Why? Add in tuition costs to such long training compared with other degrees and the commitment becomes an overwhelming millstone of a burden.”
Are you referring to Student Loans here? Bursaries are something different

“The door has been banged shut for bright children in working-class communities who are unlikely to be unable to sustain the high costs involved in their training including mandatory International Medicine where trainee doctors work abroad and fund it entirely by themselves.”
I had thought that there were grants available for the International Med, and our students spend far less time “abroad” than most med students from other Western EU countries do.

Royal College examinations are held in only a few venues so significant travel and overnight costs can add up to say nothing of the private cost of training for them. The charge for the actual piece of paper (the Royal College qualification) can cost from £300 – £500 and it is remains the property of the Royal College.

I wasn’t referring to Student Loans whatsoever but annual tuition costs. Although medics often exhaust their student loan borrowing and turn to Professional Loans as well to get through the long medical school training.

In addition, it is ‘expected’ that medical students follow an extra year pursuing a Masters or similar qualification.

Medical students often change rotations on a four monthly basis having to move flats and landlords accept 6 monthly contracts so often they have to pay this whilst staying for only four months before moving to a different hospital trust miles away..

Training to teach graduates can be paid up to £27k for the year they spend in school ie they are regarded and paid as supernumerary new teachers.

There are no mandatory grants for International medicine nor are medics paid a salary when working in hospitals abroad.

Your question ‘why?’ to the lack of investment and planning on behalf of successive governments is precisely the thrust of my comments. Blair and May have done nothing to plan for attracting and training our own doctors .

Entry into the professions involves serious financial commitment and definitely by medical students and their families compared with the generic three year degree. Millburn’s report about ‘disadvantage’ adds to the pot but I wasn’t restricting my comments to ‘white disadvantaged’ children in any way.

Interesting that Milburn (Ex Labour Sec of State for Health who retired to ‘spend more time with his family’) is making money as a director of a major equity company receiving serious income form NHS contracts.

Add to the mix Hunt, increased number of patients, real cuts in NHS spending, sustained attacks by the Daily Heil, early retirement of experienced doctors, the Tory/DUP implementation of US health care models of care and you have the perfect storm for the NHS being in deep, deep trouble.

Still the public are sleep walking into allowing the Tory/DUP government to end the NHS with the introduction of US for profit health companies

I may have got this wrong, I understand that RMBC are working with NHS partners to help facilitate the introduction of Accountable Care Organisations, is this correct?

Albion
Please don’t fall for the cop out of only blaming May.
Blair and Brown did their own share of screwing things up; introducing tuition fees, privatising the NHS and not planning and investing for sustainability of the NHS including the training of doctors.